Pathogenic bacteria and risk factors for pulmonary infections complicating acute left heart failure in the elderly and the predictive value of their predictive models
OBJECTIVE To investigate the pathogenic bacteria and risk factors of pulmonary infections complicating acute left heart failure in the elderly and the predictive value of their predictive models.METHODS The clinical da-ta of 116 elderly patients with acute left heart failure admitted to Lianyungang City First People's Hospital from Jan.2020 to Jul.2022 were retrospectively analyzed,and the patients were divided into the infection group(65 ca-ses)and the non-infection group(51 cases)according to the pulmonary infection status.The pathogenic bacteria of pulmonary infections in elderly patients with acute left heart failure were counted,and the risk factors for pulmo-nary infections were summarized,and a prediction model was constructed,and the predictive value of the predic-tion model for elderly patients with acute left heart failure complicated with pulmonary infection was analyzed u-sing the receiver operating characteristics(ROC)curve.RESULTS A total of 51 strains of pathogenic bacteria were culturally isolated from 65 elderly patients with acute left heart failure complicated with pulmonary infection,of which 3 strains of fungi accounted for 5.88％,16 strains of gram-positive bacteria accounted for 31.37％,and 32 strains of gram-negative bacteria accounted for 62.74％.Age,comorbidity with diabetes mellitus,history of anti-biotic and hormone abuse,and cardiac function class Ⅳ were the risk factors for the complication of pulmonary in-fections in elderly patients with acute left heart failure(P＜0.05).The predictive model was constructed as fol-lows:logit(P)=-10.673+age ≥80 years ×1.011+diabetes mellitus ×0.978+history of antibiotic and hor-mone abuse × 1.033+cardiac function grade Ⅳ × 0.896.ROC analysis showed that the area under the curve(AUC)of the predictive model for predicting pulmonary infection in elderly patients with acute left heart failure was 0.841,with the sensitivity of 69.23％and the specificity of 80.39％.CONCLUSION Gram-negative bacteria were the main pathogens of pulmonary infection in elderly patients with acute left heart failure,and the risk fac-tors for infections included age,comorbid diabetes mellitus,a history of antibiotic and hormone abuse,and cardiac function class Ⅳ,according to which the established prediction model for pulmonary infection in elderly patients with acute left heart failure had a good predictive value.
Acute left heart failureElderlyPulmonary infectionPathogenic bacteriaRisk factorPrediction model
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